Acute hepatitis C virus infection in incarcerated injection drug users
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Acute hepatitis C virus infection in incarcerated injection drug users. / McGovern, Barbara H; Wurcel, Alysse; Kim, Arthur Y; Schulze zur Wiesch, Julian; Bica, Ioana; Zaman, M Tauheed; Timm, Joerg; Walker, Bruce D; Lauer, Georg M.
in: CLIN INFECT DIS, Jahrgang 42, Nr. 12, 15.06.2006, S. 1663-1670.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Acute hepatitis C virus infection in incarcerated injection drug users
AU - McGovern, Barbara H
AU - Wurcel, Alysse
AU - Kim, Arthur Y
AU - Schulze zur Wiesch, Julian
AU - Bica, Ioana
AU - Zaman, M Tauheed
AU - Timm, Joerg
AU - Walker, Bruce D
AU - Lauer, Georg M
PY - 2006/6/15
Y1 - 2006/6/15
N2 - BACKGROUND: The Centers for Disease Control and Prevention has emphasized the need for interventional programs regarding hepatitis C virus (HCV) infection for injection drug users, the group of persons who are at highest risk of acquiring acute infection.METHODS: We designed a pilot study to assess the feasibility of identifying injection drug users with acute HCV infection in correctional and detoxification facilities. On-site medical providers were educated regarding risk factors and signs and symptoms of infection and were instructed to refer all patients with hepatitis to our specialty clinic.RESULTS: Over a 30-month period, 21 patients received a diagnosis of acute hepatitis C, 3 received a diagnosis of hepatitis B, and 1 received a diagnosis of hepatitis A. Of the 21 patients with acute hepatitis C, 19 were identified in the prison setting shortly after incarceration. Of the 17 patients who were observed serially (mean duration of observation, 6.3 months), 8 had spontaneous virologic clearance. Early therapy with pegylated interferon was initiated for 5 patients with persistent viremia and led to a sustained virologic response in 2 individuals. All patients agreed to undergo human immunodeficiency virus counseling and testing, as well as to receive immunization for hepatitis A and B.CONCLUSIONS: Incarceration presents a unique opportunity to identify injection drug users with acute HCV infection, to initiate counseling regarding other bloodborne pathogens, and to facilitate immunizations and HCV treatment.
AB - BACKGROUND: The Centers for Disease Control and Prevention has emphasized the need for interventional programs regarding hepatitis C virus (HCV) infection for injection drug users, the group of persons who are at highest risk of acquiring acute infection.METHODS: We designed a pilot study to assess the feasibility of identifying injection drug users with acute HCV infection in correctional and detoxification facilities. On-site medical providers were educated regarding risk factors and signs and symptoms of infection and were instructed to refer all patients with hepatitis to our specialty clinic.RESULTS: Over a 30-month period, 21 patients received a diagnosis of acute hepatitis C, 3 received a diagnosis of hepatitis B, and 1 received a diagnosis of hepatitis A. Of the 21 patients with acute hepatitis C, 19 were identified in the prison setting shortly after incarceration. Of the 17 patients who were observed serially (mean duration of observation, 6.3 months), 8 had spontaneous virologic clearance. Early therapy with pegylated interferon was initiated for 5 patients with persistent viremia and led to a sustained virologic response in 2 individuals. All patients agreed to undergo human immunodeficiency virus counseling and testing, as well as to receive immunization for hepatitis A and B.CONCLUSIONS: Incarceration presents a unique opportunity to identify injection drug users with acute HCV infection, to initiate counseling regarding other bloodborne pathogens, and to facilitate immunizations and HCV treatment.
KW - Adult
KW - Antiviral Agents/therapeutic use
KW - Female
KW - Hepacivirus/genetics
KW - Hepatitis C/complications
KW - Humans
KW - Male
KW - Middle Aged
KW - Phylogeny
KW - Pilot Projects
KW - Prisoners/statistics & numerical data
KW - RNA, Viral/blood
KW - Substance Abuse, Intravenous/complications
KW - Viral Load
KW - Viremia
U2 - 10.1086/504327
DO - 10.1086/504327
M3 - SCORING: Journal article
C2 - 16705568
VL - 42
SP - 1663
EP - 1670
JO - CLIN INFECT DIS
JF - CLIN INFECT DIS
SN - 1058-4838
IS - 12
ER -